Endoscopic ultrasound guided drainage of necrotic pancreatic fluid collections: a monocentric experience

Up to 20% of patients with acute pancreatitis will develop necrosis which may be categorized as either an acute necrotic collection (ANC) or walled-off necrosis (WON). Many patients with pancreatic necrosis require intervention for complications such as infection, gastrointestinal obstruction, persistent pain or inflammation. Current international guidelines advise postponing invasive interventions for pancreatic necrosis until the stage of WON has been reached, that is usually at least 4 weeks after disease onset.

We present eleven patients who underwent endoscopic drainage of WON of the pancreas using endoscopic ultrasound (EUS), of which eight patients were successfully (72%) managed and three succumbed to their illness due to complications. Three patients needed additional surgical drainage of endoscopically inaccessible para colic collections.

EUS guided drainage is an effective and successful, minimally invasive method to drain WON in the appropriate patient.